study to separately evaluate the activity of talacotuzumab (jnj-56022473) or daratumumab in transfusion-dependent participants with low or intermediate-1 risk myelodysplastic syndromes (mds) who are relapsed or refractory to erythropoiesis-stimulating agent (esa) treatment

Conditions: Myelodysplastic Syndromes

Summary: the main purpose of the study is to evaluate the efficacy (transfusion independence \[ti\]) of talacotuzumab (jnj-56022473) or daratumumab in transfusion-dependent participants with low or intermediate-1 risk myelodysplastic syndrome (mds) whose disease has relapsed during treatment with or is refractory to erythropoiesis-stimulating agent (esas).

this is a multicenter, randomized (study drug assigned by chance), open-label (participants and researchers are aware of the treatment participants are receiving) study to evaluate the safety and efficacy of talacotuzumab or daratumumab. approximately 60 participants (30 to receive talacotuzumab and 30 to receive daratumumab) will be enrolled and then assigned randomly on a 1:1 basis to receive either talacotuzumab or daratumumab. the study consists of: a screening phase of up to 28 days during which participant eligibility will be reviewed and approved by the sponsor prior to randomization, a treatment phase that will extend from the first dose on cycle 1 day 1 until study drug discontinuation, and a post-treatment follow up phase beginning once the participant discontinues talacotuzumab or daratumumab. study drugs will continue to be administered until disease progression, lack of response, unacceptable toxicity, withdrawal of consent, or study end. safety will be monitored throughout the study. the talacotuzumab arm of the study is closed for enrollment.

Eligibility criteria:
inclusion criteria: * myelodysplastic syndrome (mds) according to world health organization (who) criteria confirmed by bone marrow aspirate and biopsy within 12 weeks prior to first dose. a local laboratory report from this diagnostic bone marrow aspirate and biopsy must be approved by the sponsor * international prognostic scoring system (ipss) low risk or intermediate-1 risk mds * red blood cell (rbc) transfusion dependent, 1) received at least 4 units of rbcs over any 8 consecutive weeks during the 16 weeks prior to randomization, 2) pretransfusion hb must have been less than or equal to (\<=)9.0 gram per deciliter (g/dl) * adequate iron stores, defined as transferrin saturation greater than 20 percent (%) and serum ferritin greater than 400 nanogram per milliliter (ng/ml), measured within the screening period, or adequate iron stores as demonstrated by recent (within 12 weeks prior to first dose) bone marrow examination with iron stain * eastern cooperative oncology group (ecog) performance status 0, 1 or 2 exclusion criteria: * known allergies, hypersensitivity, or intolerance to talacotuzumab and daratumumab or their excipients * received any chemotherapy, immunomodulatory or immunosuppressive therapy, corticosteroids (greater than \[\>\]30 milligram per day \[mg/day\] prednisone or equivalent) within 28 days prior to randomization * received other treatments for mds within 28 days prior to first dose (example \[eg\], azacitidine, decitabine, lenalidomide, erythropoiesis-stimulating agent (esa) (8 weeks for long-acting esas) * history of hematopoietic stem cell transplant * del(5q) karyotype unless treatment with lenalidomide has failed. failure is defined as either: 1) having received at least 3 months of lenalidomide treatment without rbc transfusion benefit (international working group \[iwg\] 2006); 2) progression or relapse after hematologic improvement with lenalidomide (iwg 2006); 3) discontinuation of lenalidomide due to toxicity; or 4) unable to receive lenalidomide due to a contraindication. source documentation for lenalidomide treatment failure must be verified by the sponsor